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address 


Charles  E.    Johnson 


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THE   UNIVERSITY 

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AN  ADDRESS 


BEFORE   TKE 


MEDICAL  SOCIETY  OF  NORTH  CAROLINA, 


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ITS    SECOND    ANNUAL    MEETING, 


IS  RALEIGH,  MAY  1851, 


BY  CHARLES  E.  JOHNSON,  M.  D, 


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Cum  nil  sine  ordine  et  lege  fiat,  ita  vitae  nostrae  integritas  naturali  lege  constat,  et 
nobis  hanc  investigare  legem;  sed prinsqnam  ad  nos  spectat  cognosoere  ignorentiam. 


RALEIGH  i 

SEATOff  GALES,  PUBLISHER,  REGISTER  OFFICE. 


1851. 


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I! 


A  N  -A  D  I)  E  E  S  S 


BEFORE   THE 


MEDICAL  SOCIETY  OF  NORTH  CAROLINA, 


ITS    SECOND    ANNUAL    MEETING, 


IN  RALEIGH,  MAY  1851, 


BY  CHARLES  E,  JOHNSON,  M,  D, 


Cum  nil  sine  ordino  et  lege  fiat,  ita  vitae  nostrae  integritas  naturali  lege  constat,  et 
nobis  banc  investigate  legem ;  sed  priusquam  ad  nos  spectat  cognoscere  ignorentiam. 


RALEIGH: 

SEATON  GALES,  PUBLISHER,  REGISTER  OFFICE. 
1851. 


Digitized  by  the  Internet  Archive 

in  2012  with  funding  from 

University  of  North  Carolina  at  Chapel  Hill 


http://archive.org/details/addressbeforemedOOjohn 


ADDRESS. 


Mr.  President  and  Gentlemen 

of  the  Medical  Society  of  the  State: 

It  is  with  no  ordinary  feelings  of  embarrassment  and  with  a 
profound  distrust  of  my  ability  to  contribute  any  thing  of  import- 
ance to  your  deliberations,  that  I  appear  before  you  on  this  interest- 
ing occasion,  in  the  novel  character  of  a  Public  Speaker.  Although 
I  consider  myself  one  of  the  very  humblest  of  the  gallant  lew,  who 
have  stepped  forward  in  the  good  work  of  Medical  Reform  in  North 
Carolina,  "to  perform  the  tasks  of  hope  in  the  midst  of  despair,'' 
yet  I  have  not  felt  at  liberty,  from  any  considerations,  however 
gratifying  to  me  personally,  to  shrink  from  the  discharge  of  the  re- 
sponsible duty  which  your  partiality  has  assigned  me. 

Here  I  might  be  permitted  to  say  many  very  civil,  pleasant, 
and  truthful  things  of  the  Medical  Profession,  nor  would  it  be 
what  the  Lawyers  call  a  '-departure,''  since  it  is  as  clearly  within 
the  object  of  our  Society  to  say  a  kind  word  of  our  professional 
brethren,  as  it  is  to  inveigh  against  follies,  vulgarities  and  vices, 
qualities  which  the  pretenders  in  medicine  have  in  common  with 
some  men  of  other  pursuits.  Whilst,  therefore,  I  am  compelled  to 
admit  that  there  are  some  practitioners  of  Medicine,  who  are  pur- 
suing in  a  most  unworthy  manner,  our  highly  honorable  and  truly 
useful  profession,  I  wish  to  be  distinctly  understood  to  assert,  that 
neither  the  causes  which  originate  or  aggravate  their  vices  are  ne- 
cessarily incident  to  the  profession  itself.  That  such  an  objection- 
able state  of  things  should  exist  is,  perhaps,  mainly  our  own  fault, 
but  partly  owing,  I  believe,  to  the  lack  of  a  general  diffusion  of 
useful  knowledge,  and  to  the  existence  on  our  statute  book,  of  a 
very  pernicious  law.     By  reference  to  our  Revised  Statutes,  it  will 


be  found,  that  all  sorts  and  degrees  of  Doctors,  from  thePcoot  and 
Cancer  and  Thompsonian  Doctors,  up  to  the  regularly  educated 
and  highly  polished  gentleman  and  physician,  stand  upon  the 
same  footing,  and  enjoy,  under  the  law,  the  same  privileges  and  im- 
munities as  to  the  Doctorate. 

It  is  astonishing  how  soon  one  of  these  pretenders  will  learn 
to  cheat  the  public.  He  takes  all  advantages  and  seems  to  have 
no  idea  of  any  other  principle.  Cunningly  mysterious  and  secret 
as  to  the  sources  of  his  knowledge  and  the  means  which  he  employs 
in  the  treatment  of  disease,  he  soon  becomes  a  trading  sycophant 
and  flatterer,  pandering  to  the  pride  and  pleasures  of  tne  few,  and 
ministering  to  the  prejudices  and  ignorance  of  the  many,  whilst  his 
own  mind  is  impenetrable  to  a  single  my  of  liberal  knowledge,  is 

"Xot  pierceable  by  power  of  ahy  star." 

However,  I  shall  not  discuss  here  the  legal  privileges,  nor  the 
cherished  errors  oi  these  charlatans,  who  are  so  well  versed  in  the 
"gospel  of  enlightened  selfishness"  as  to  deny  the  importance  of 
every  consideration,  the  value  of  which  they  cannot  estimate  in  dol- 
lars and  cents.  Nothing  is  to  be  made  by  an  argument  with  or  a- 
bout  them.  That  sort  of  gratuitous  advertisement  would  only  en- 
able them  the  more  readily  to  climb  up  into  public  view,  confident, 
in  their  own  minds,  that  the  application  of  the  old  adage,  "who 
shall  decide  when  Doctors  disagree,"  could  not  result  to  their  dis- 
advantage. It  will  not  be  expected  of  me,  therefore,  to  occupy 
your  time  wlthany  farther  allusion  to  them  particularly,  as  I  de- 
sire to  make  a  few  remarks,  before  I  pass  on  to  the  consideration  of 
the  proper  subject  of  this  essay,  in  defence  of  the  profession  of 
medicine,  the  peculiar  advantages  we  possess  for  prosecuting  the 
study  of  it  successfully,  and  in  praise  of  those  noble  spirits  who 
bring  to  the  practice  of  their  art,  learning,  humanity,  discretion  and 
integrity,  the  four  cardinal  virtues  of  a  really  deserving  physician. 

It  is  as  true  now,  as  ever,  that  the  services  of  a  learned  and 
skilful  physician  are  of  such  vital  importance  to  mankind,  that  if 
medical  men  will  take  care  to  be  distinguished,  as  a  body,  for  their 
humanity  and  integrity,  their  knowledge  and  acquirements,  and 
their  high-toned  gentlemanly  bearing  and  kind  offices  toward  each 
other,  they  will  soon  ensure  the  perfect  confidence  and  entire  respect 
of  their  fellow  men  ;  whilst  the  blunders,  ignorance  and  miscon- 
duct of  unqualified  pretenders,  would  attach  to  each  undeserving 
one  of  them,  agreeably  to  his  worthlessness,  rather  than  to  the  pro- 


fession  itself.  Then,  there  would  be  more  hope  of  a  moral  regene- 
ration of  the  profession  than  croakers  will  allow  is  possible,  because 
the  sordid  and  selfish  even  will  begin  to  discover  that  a  thorough 
devotion  to  professional  science  and  duty  is  the  surest,  if  not  the 
shortest,  way  to  wealth  and  importance  ;  and  wisdom  once  acquir 
ed,  no  matter  what  the  motives  were  which  prompted  the  acquisi- 
tion, will  be  faithfully  cherished  afterwards,  not  only  for  the  advan- 
tages it  can  confer,  but  for  its  loveliness  and  virtue.  The  wise 
man,  in  describing  the  advantages  of  the  love  of  wisdom  and  virtue, 
says:  "Length  of  days  is  in  her  right  hand,  and  in  her  left  hand, 
riches  and  honor."  But  in  my  humble  judgment,  the  members  of 
the  profession,  who  undertake  the  study  and  practice  of  medicine 
with  a  full  knowledge  of  its  relations  with  the  various  wants,  pur- 
suits and  purposes  of  life,  and  with  a  determination  to  be  prepared 
to  meet  these  exigencies,  are  more  deserving  of  praise  for  merit  of 
every  kind  than  the  world  is  in  the  habit  of  according  to  them. 

"  A  Physician  skilled,  our  •wounds  to  heal, 
Is  more  than  armies  to  the  public  weal," 

is  the  testimony  of  him,  who,  nearly  a  thousand  years  before  the 
beginning  of  our  era,  sang  of  Troy  and  her  fall;  and  shall  it  be 
said  in  this  so  justly  called  age  of  progress,  when  invention  is 
every  day  discovering  new  and  unappropriated  objects  of  interest, 
and  opening,  by  experiment  and  the  inductive  method  of  reasoning, 
new  fields  of  enquiry  in  which  every  man  may  take  an  even  start, 
that  the  humble,  but  earnest  and  truthful  disciple  of  vEsculapius 
is  a  less  useful,  important,  and  respectable  member  of  society  than 
he  was  in  those  ruder  times?  No;  it  cannot  be.  I  will  not  be- 
lieve it.  The  love  of  useful  knowledge  not  only  still  exists,  but 
even  burns  with  a  more  ardent  glow  than  at  any  former  period  of 
the  world's  history.  Many  circumstances  conspire  to  produce  this 
condition  of  things.  It  is  not  owing  to  any  change  in  man's  na- 
ture, peculiar  to  this  age,  for  human  nature,  without  doubt,  has  been 
the  same  in  every  enlightened  age  and  nation,  but  results  in  part 
from  the  higher  incentives  to  cultivation  and  the  greater  rewards 
offered  to  industry.  Wherever  these  are  liberally  provided,  there 
every  faculty  of  mind  and  body  will  be  exerted  to  the  utmost,  and 
man  will  furnish  the  most  numerous  and  shining  examples  of  hu- 
man perfection.  Besides,  along  with  these  inducements  for  the  ar- 
dent pursuit  of  useful  knowledge,  we  are  the  fortunate  heirs  of  time, 
who  have  acquired  by  inheritance   all  the  advantages  of  the  expe- 


rience  and   wisdom  which  history  teaches.     Mounted,  as  it  were, 
upon  the  shoulders  of  those  who  have  preceded  us  in  the  pathway 
of  human  progress,  we  enjoy  a  more  extended  horizon  than  met 
their  view.     No  narrow  limits  contract  the  sphere  of  our  intellect- 
ual vision,  but  the  whole  boundless  world  is  ours.     Much,  too,  is 
clue  to  Protestantism,  which  has  achieved  wonders  in  philosophy 
as  well  as   religion,  and  is  one  of  the  distinguishing  peculiarities 
and  most  valuable  characteristics  of  the  present  age.     In  our  day, 
the  inquirer  after  Catholic  truth,  in  all  the  departments  of  knowl- 
edge, in  the  exact  sciences   and  speculative  philosophy,  as  in  reli- 
gion, can  pursue  his  object  with  a  Protestant  spirit.     No  longer  the 
Schools  are  connected  with  the  Vatican,  producing  a  degree  of  men- 
tal  vassalage   and  subserviency,  destructive  of  the  spirit  of  free  in- 
quiry.    No  longer  the  word  of  a  Priest  or  Master,  or  a  dogma  of 
the  schools,  is  the  test  of  truth,  but  the  immortal  mind,  whose  ca- 
pacity for  knowledge  and  wisdom  is  increased  the  more  it  is  stored 
with  useful  treasures,  is  left  that  full  liberty  to  combat  error  or  pur- 
sue truth,  which   is  so  characteristic  of  the  age  we  live  in.     And  if 
it  be   the  honor,  as  I  believe   it  is,  as  well  as  the  character  of  this 
age,  that  genius  and  learning,  not  less  than  christian  benevolence, 
are  chiefly  busy  in    the  habitations  of  men,  and  around  the  walks 
of  daily  life,  and  that  the  greatest  men,  as  well  as  the  best,  find  their 
themes  of  study,  and  their  sources  of  inspiration  in  the  moral  and 
physical  wants  of  mankind,  then,  in  such  an  age,  and  especially  in 
a  country  like  ours,   where   we  have  in  our  governmental  policy 
avoided  the  cherished  prejudices  and  tolerated  errors  of  long  estab- 
lished  despotism,  on  the  one  hand,   and  escaped  from  the  greater 
evils  of  fanaticism,  unrestrained  by  law,  on  the  other,  "  he  who  will 
not  reason  is  a  bigot,  he  who  cannot  reason  is  a  fool,  and  he  who 
dares  not  reason  is  a  slave."     God  has  given  man  the  peculiar  fac- 
ulty of  reason   to   guide  him  wisely,   and  therefore  safely,  in  the 
pursuits  of  life,  and  he   who  will  not  exercise  it  vigorously  and 
healthfully   in  the  progress  of  events,  will  presently  find  himself 
trodden  down   and  crushed   beneath  the  feet  of  the  rushing  multi- 
tude whose  onward  course  he  obstructs.     Let  not  this  be  the  lot 
of  any  one  of  us.     9n  the  contrary,  let  each  of  us,  not  only  in  his  indi- 
vidual character  andposition,butlikewisein  his  associated  character, 
press  on  to  the   attainment  of  the  objects  and  purposes  of  his  high 
calling,  emulating  the  lives  and  conduct  of  the  masters  in  our  pro- 
fession, who  have  taken  their  stand,  shoulder  to  shoulder,  in  the 


foremost  ranks   with  those  philosophers  who  have  inscribed  their 
names  high  in  the  temple  oi  fame. 

In  the  anticipation  of  a  glorious  future,  the  youthful  and  am- 
bitious student  finds  the  highest  incentive  diligently  to  prepare 
himself  for  the  active  and  honorable  course  he  means  to  run  ;  and 
the  older  ones  find  it  necessary  to  labor  faithfully  in  their  several 
callings,  that  they  may  wear  the  honors  of  experience  gracefully 
and  not  be  outstripped  by  their  more  youthful  and  equally  well  in- 
formed competitors.  So,  as  there  is  no  privileged  road  to  knowl- 
edge and  usefulness,  every  competitor,  whatever  his  age  and  condi- 
tion in  life,  who  struggles  to  win  and  wear  a  distinction  worth  pre- 
serving, must  undergo  the  same  painful  discipline  of  mind  and  la- 
borious exertion.  But  let  him  who  runs  take  heed  lest  he  fall,  mis- 
taking the  feverish  excitement  and  fitful  energy  of  a  sanguine  tem- 
perament for  a  true  and  noble  ambition,  and  a  momentary  popular- 
ity for  lasting  renown.  All  this  is  true  of  the  study  and  practice  of 
medicine,  and  I  am  persuaded  that  the  former,  if  carried  on  with  a 
full  knowledge  of  its  important  duties  and  relationships  with  the 
well  being  of  society,  is  ennobling  in  its  very  nature ;  and  that  the 
latter  is  honorable  and  will  be  remunerative,  when  conducted  un- 
der the  influence  of  that  preparation,  hopefulness,  and  patience, 
which  enable  us  to  be  contented  with  small  beginnings,  but  keep  us 
always  ready  for  the  gradually  widening  sphere  of  useful  labors 
that  certainly  awaits  us.  We  must  remember  though,  if  we  hope  to 
succeed,  always  to  have  some  good  objector  useful  purpose  in  view ; 
and  even  in  our  moments  of  relaxation  from  the  severer  studies  and 
arduous  labors  of  our  profession,  not  to  turn  exactly  into  the  "prim- 
rose path  of  dalliance,"  but  endeavor  to  cultivate  an  acquaintance  with 
thsse  kindred  sciences,  which  develop  the  mental  faculties,  and  a  taste 
for  polite  literature  wh  ich  gives  them  harmony,  and  to  acquire  a  chris- 
tian spirit,  that  we  may  have  it  in  our  power  to  contribute  to  the  refine 
ments,  as  well  as  happiness  of  the  social  circle.  This  course  of  men- 
tal gymnastics  will  not  only  enable  us  to  investigate  wtth  facility 
and  scrutiny  the  advantages  and  disadvantages  of  all  the  facts  and 
theories,  which  are  continually  coming  out  of  the  prolific  laborato- 
ries of  medical  Philosophers,  but  likewise  to  discharge  the  onerous 
duties  of  our  profession  more  as  a  pleasure  than  as  a  task. 

•'Tis  not  for  mortals  to  command  success 

But  we'll  do   more,  Sempronius,  we'll  deserve  it." 

Lord  Bacon  regarded  the  science  of  medicine  with  the  great- 


est  interest.  He  aimed  at  the  relief  of  "man's  estate,"  and  this  he 
believed  was  to  be  accomplished  as  well  by  mitigating  human  suf- 
fering as  by  multiplying  human  enjoyment.  The  study,  therefore, 
of  the  to  kalon  and  to  eidolon  of  the  old  philosophers,  however 
well  calculated  it  may  have  been  to  sharpen  the  wit  or  refine  the 
rhetoric  of  the  schoolmen,  contributed  but  little,  according  to  the 
views  of  this  great  man,  to  alleviate  the  pains,  or  lessen  the  burdens 
of  suffering  humanity.  Considered  in  relation  to  these  great  ob- 
jects, he  regarded  the  science  of  medicine  as  the  most  important  de- 
partment of  knowledge,  because  it  was  capable  of  conferring  the 
most  desirable  benefits  on  mankind. 

In  this  connection,  too,  it  will  not  be  improper  to  elevate  our 
thoughts  and  recollect  that  "the  great  physician  of  the  soul  did  not 
disdain  to  be  also  the  physician  of  the  body."  How  gratifying  to 
the  mere  philanthropist  and  physician  are  the  views  and  opinions  of 
Bacon!  How  cheering  and  sustaining  to  the  enlightened,  laboring 
physician,  who  is  at  the  same  time  a  christian  man,  to  know,  that 
in  some  degree,  at  least,  he  is  following  the  example  of  his  Divine 
Master  !  Again ;  the  dangers  the  medical  man  encounters,  and  en- 
counters alone,  unsupported  by  the  emulous  spirit  and  confidence 
of  numbers, 

"All  the  while 

Sonorous  metal  blowing  martial  sounds," 

are  as  much  greater  than  those  of  the  soldier  in  the  battle  field,  as 
the  calm  deliberation  of  high  purposes  and  conscious  rectitude  is 
superior  to  the  mere  enthusiasm  of  excited  courage.  Aye,  and  if 
he  falls,  as  he  oftentimes  does,  fighting  with  deadly  disease,  in  his 
lonely  walks  amidst  pestilence  and  famine,  no  funeral  honors  at- 
tend upon  him,  no  public  provisions  await  his  family.  His  is  the 
honor  only  to  have  acted  well  the  things  that  belong  to  the  sad  re- 
alities and  pressing  necessities  of  human  life — h'"s  the  honor  to  have 
been  a  co-worker  with  those  great  and  good  men,  by  whose  con- 
stant toils,  and  energetic  labors  and  self-sacrificing  spirits,  mankind 
have  been  ever  blessed.  Hence  it  is  with  some  assurance,  although 
with  an  humble  spirit,  I  assert,  that  the  diligent  and  enlightened  pur- 
suit of  so  honorable  a  calling  as  ours,  for  honest  purposes,  is  faith- 
fully to  serve  God. 

But  I  must  turn  from  this  agreeable  theme,  and  the  further  e- 
lucidation  of  it,  inviting  as  it  is,  and  direct  your  attention  to  the 
proper  subject  of  this  essay,  in  which  I  propose  to  discuss  the  doc- 
trine of  the  miasmatic  origin  of  disease. 


9 

The  acquisition  of  as  complete  and  perfect  a  knowledge  of  the 
causes  of  diseaae,  as  may  be  attainable,  is  so  obviously  useful  to 
the  general  practitioner,  that  it  will  not  be  necessary  for  me  to  in- 
sist upon  it  here  ;  for  although  the  nature  and  seat  of  the  malady 
be  equally  well  known,  and  the  method  of  treatment  thorough/  un- 
derstood, it  is  nevertheless  of  great  importance  to  be  able  to  refer  to 
its  cause,  which,  indeed,  after  giving  rise  to  the  disease,  may  still 
continue  to  operate  injuriously  by  its  presence.  Now,  as  this  is 
especially  true  of  that  class  of  disorders,  commonly  denominated 
malarious  or  miasmatic  diseases  ;  and  as  these  diseases  and  their 
causes  should  be  particularly  objects  of  study  and  inquiry  with  ma- 
ny, if  not  most  of  the  physicians  of  North  Carolina,  I  shall  assign 
no  other  reason,  because  I  believe  I  can  adduce  no  higher  one,  for 
making  their  Etiology  the  subject  of  this  communication.  On  the 
other  hand,  I  do  not  mean  to  be  prevented  from  expressing  my  o- 
pinion  in  the  premises,  because  it  is  too  commonly  the  case,  that 
he,  who  undertakes  to  direct  the  professional  or  public  mind  to  ob- 
jects of  etiological  reform,  is  more  apt  to  be  considered  a  visionary 
theorist,  than  a  zealous  and  intelligent  advocate  of  sanatary  im- 
provements. Nor  shall  I  bring  forward,  just  now,  any  other  theory 
to  explain  these  phenomena,  as  an  excuse  or  apology  for  what  I  have 
to  say  in  opposition  to  the  received  notions  upon  this  subject.  En- 
tertaining, as  I  do,  the  firm  conviction,  that  the  first  important  step  in 
a  practical  investigation  is  the  removal  of  any  error  with  which  it 
may  be  encumbered,  it  is  sufficient  for  my  present  purpose,  whatever 
my  ultimate  intention  may  be,  to  show  that  marsh  miasm,  in  the 
sense  of  an  exhalation  from  putrescent  vegetable  matter,  cannot  be 
the  cause  of  disease.  And,  indeed,  it  would  not  be  a  difficult  mat- 
ter to  bring  forward  evidence  to  prove  that  if,  instead  of  sitting  down 
quietly  under  the  persuasion  of  the  existence  of  this  thing,  marsh 
miasm,  an  inappreciable  essence,  about  which  they  cannot  agree, 
medical  men  and  the  civil  authorities  would  earnestly  and  wisely 
exert  themselves  to  discover  the  real  nature  and  sources  of  morbific 
agents,  the  result  would  be  an  astonishing  diminution  of  the 
liabilities  to  disease  and  the  rates  of  morality.  It  is  apparent, 
therefore,  in  regard  to  this  question,  that  I  consider  it  one  of  some 
little  importance,  at  least,  to  the  skilful  physician  of  the  South- 
ern States,  involving  as  it  does,  the  every  day  application  almost 
of  the  principles  of  practical  etiology,  which  I  understand  to  be 
the  establishment  of  the  invariable  relationship,  as  cause  and  ef- 
2 


to 

feet,  of  those  agents  or  influences  that  are  capable  of  producing  dis- 
eases and  the  diseases  themselves.  This,  I  believe,  the  sequel  will 
show  is  not  the  case  with  miasm  and  the  so-called  miasmatic  dis- 
eases. 

I  know  that  in  advancing  this  opinion,  I  am  impinging  upon 
the  current  prejudices  and  dogmas  of  the  schools,  andj  perhaps,  upon 
the  opinions  of  most,  if  not  all,  of  the  medical  gentlemen  here  as- 
sembled. But,  let  me  ask  you,  in  all  sincerity,  have  you  not  adop- 
ted, as  a  portion  of  your  early  professional  education,  your  belief 
in  the  miasmatic  origin  of  disease  ?  Have  you  faithfully  and  phil- 
osophically investigated  its  claims  to  validity  and  truth,  and  after 
due  inquiry,  yielded  it  your  full  credence  because  you  could  not  re- 
sist the  overwhelming  evidence  in  its  favor?  Or,  have  you  hot 
unpardonably  cherished  an  error,  because  it  was  a  popular  one,  or 
because  it  furnished  you  with  an  easy,  if  not  satisfactory  solution, 
of  a  difficult  question  1  Or,  have  you  not  preferred  to  rest  on  a 
foregone  conclusion,  not,  at  bottom,  really  embracing  any  well 
tried  fact,  or  established  principle,  rather  than  be  troubled  or  dis- 
turbed about  that  on  which  you  have  already  made  up  your  minds  ? 
Or,  acting  still  more  culpably,  and  upon  the  well  known  maxim  of 
Bolingbroke,  "that  whilst  plain  truth  may  influence  half  a  score  of 
men,  mystery  will  lead  millions  by  the  nose, ''  have  not  medical 
men,  from  the  days  of  Lancisi  down  to  the  present  time,  used  the 
term  miasm  or  malaria,  as  a  sort  of  convenient  cloak  for  covering 
up  their  real  want  of  information  upon  this  subject,  and  thus  hid- 
ing their  ignorance  from  the  public  gaze?  And  is  this  the  prop- 
er method,  think  you,  of  conducting  an  investigation  after  truth, 
reasonable  truth,  especially  by  those  who  seek  it  for  the  ennobling 
purpose  of  remedying  the  "ills  that  flesh  is  heir  to  ?"  Surely  not. 
For,  after  all,  the  expression,  marsh  miasm,  as  denoting  the  cause 
of  disease,  is  notliing  more  than  a  mere  theoretical  way  of  announc- 
ing the  fact  that  something  exists,  of  the  nature  and  source  of  which 
we  are  ignorant,  for  the  production  of  these  diseases,  since  it  can 
neither  be  appreciated  by  our  senses  in  their  natural  state,  nor  aided 
by  all  the  artificial  contrivances  which  ingenuity  can  suggest,  nor 
traced  even  by  the  presence  of  those  agencies  which  are  said  to  be 
capable  of  generating  it. 

Educated  to  believe,  with  entire  confidence,  in  the  theory  of 
the  miasmatic  origin  of  disease,  it  was  not  long  after  I  commenced 
the  practice  of  my  profession  in  one  of  the  paludial  districts  of  this 


11 

State,  before  I  began  to  doubt  the  sufficiency  of  the  facts   and  ar- 
guments upon  which  the  doctrine  rested.     Subsequent  observations,, 
and  a  more  enlarged   and  matured  experience  have  ripened  those 
doubts  into  convictions  and  I  now  regard  the  doctrine  as  a  ground- 
less assumption  or  pure  hypothesis.     Let  me  not,  however,  be  mis- 
understood on  these  points.     I  do   not  mean   to  deny   the  fact, 
well  known  to  every  observing  man,   whether  he  be  a   physician 
or  not,   that  a  low  marshy   country  is,  generally  speaking,  more 
sickly   than   a  higher,  drier,   and  better  ventilated   one.     Indeed, 
I  may  observe  in  this  connection,  that  so  far  from   denying  the 
effect  of  climate  and  position  upon   organic   life,  I  am  inclined 
to  think  there  is  some  truth  in  the  remark  of  a  distinguished  nat-. 
uralist,  made  at  a  meeting  of  Savans  in  Charleston,   South  Car- 
olina, a  year  or  two   ago,   that  he  was   so  well  acquainted  with 
the  geological  and  meteorological  conditions  of  the  State  in  which 
he  resided,  and  the  influences  they  produced,  even  upon  man,  as  to 
be  able  to  decide  in  a  given  number  of  individuals  by  their  peculiar 
characteristics,  in  what  sections   of  the  State  a  majority   of  them 
were  reared.     Nor  do  I  mean  to  assert,  what  every  educated  person 
will  deny,  that  hypotheses  are  altogether  valueless  in  every  scien- 
tific inquiry.     The  views  I  wish  to  present,  and  hope  to  maintain, 
are  simply  these  :    That   the  greater  sickliness  of  the  low  lands  is 
not  owing  to  miasm,  an  exhalation  from  decaying  vegetable  matter, 
under  certain  circumstances   of  heat   and  moisture,   the  sense   in 
which  it  is  used  by  the  schoolmen  ;  and  that  hypotheses,  to  be  of 
any  importance  in  philosophical  investigations,   must  have  such  a 
fixed  and  determinate  value  as  will  always  render  them  applicable 
under  like  circumstances,  and  inapplicable  under  dissimilar  ones. 
Locke  says,  "Hypotheses,  if  they  are  well  made,  are  at  least  great 
helps  to  the  memory,  and  often  direct  us  to  new  discoveries."'    But 
at  the  same  time,  he  gives  us   the  wholesome  caution,  "that  the 
names  of  principles  deceive  us  not,  nor  impose  on  us,  by  making  us 
receive  that  for  an  unquestionable  truth,  which  is  really  at  best  but 
a  very  doubtful  conjecture." 

Sir  Isaac  Newton  says,  "  For  the  best  and  safest  method  of  phi' 
losophizing  seems  to  be,  first,  to  inquire  diligently  into  the  proper- 
ties of  things,  and  establish  those  properties  by  experiments,  and 
then  to  proceed  more  slowly  to  hypothesis  for  the  explanation  of 
them."  But,  lest  it  may  be  said  that  Newton  had  reference  to  the 
exact  science  of  mathematics,  listen  to  the  language  of  Sir  H.  Davy, 


12 

to  whose  particular  department  of  philosophical  knowledge,  chem- 
istry, this  subject  of  miasmata  properly  belongs.  He  says,  "I  trust 
that  our  philosophers  will  attach  no  importance  to  hypotheses,  ex- 
cept as  leading  to  the  research  after  facts,  so  as  to  be  able  to  discard 
or  adopt  them  at  pleasure,  treating  them  rather  as  parts  of  the 
scaffolding  of  the  building  of  science,  than  as  belonging  to  its  foun- 
dation, materials  or  ornaments."  It  is  not  my  purpose  then,  alto- 
gether, to  condemn  hypotheses,  but  to  keep  them  in  their  proper 
places,  to  render  them  subordinate  to  the  laws  which  should  regu- 
late all  inquiries  in  the  physical  sciences.  For  example,  to  assume 
that  miasm  was  the  cause  of  disease,  the  existence  of  which  is  only 
inferred  from  the  fact  that  disease  prevails  under  circumstances  to- 
tally inexplicable,  unless  upon  the  assumption  of  the  existence  of 
such  a  cause,  would  not  be,  I  apprehend,  an  improper  method  of 
philosophizing,  provided,  on  the  one  hand,  we  always  had  the  cir- 
cumstances present  which  were  claimed  as  being  capable  of  gene- 
rating the  cause  itself,  and,  on  the  other  hand,  the  disease  invaria- 
bly following  as  a  matter  of  consequence.  Under  different  circum- 
stances, that  is,  in  the  absence  of  either  the  disease  or  the  miasm,  we 
should  have  a  cause  without  its  corresponding  effect,  or,  what 
would  be  a  much  worse  state  of  things  in  physics,  because  fatal  to 
any  theory  of  causation,  an  effect  without  a  cause. 

Now,  the  course  of  nature,  so  far  as  it  has  been  observed,  and 
is  cognizable  by  our  senses  directly  or  indirectly,  where  we  have 
been  able  by  the  aid  of  artificial  contrivances,  carefully  to  observe 
her  laws  and  operations,  is  so  uniform  in  respect  to  causes  and  ef- 
fects, and  so  specific  in  the  character  of  her  laws,  that  we  are  bound 
by  a  correct  philosophy  to  refer  the  phenomena  of  disease  to  some 
one  or  more  of  the  appreciable  states  of  the  surrounding  media, 
which  are  in  any  way  brought  into  relationship  with  our  bodies, 
or  to  intelligible  internal  agencies,  or  systemic  influences,  rather 
than  to  some  unknown  fanciful  and  inappreciable  condition  of  the 
atmosphere.  It  is  my  purpose,  therefore,  in  the  course  of  my  re- 
marks, to  show  that  the  doctrine  of  the  miasmatic  origin  of  disease 
does  not  rest  on  the  evidence  of  our  senses,  aided  or  unaided,  or 
indeed,  upon  reliable  evidence  of  any  kind  ;  but  that  it  falls  under 
the  absurdity  alluded  to  above,  namely,  of  a  cause  without  a  conse- 
quence, or  a  consequence  without  a  cause.  Hence,  the  conclusion 
to  which  I  have  come,  with  others,  that  this  theory  is  a  groundless 
assumption,   unsupported   by  such  facts  and  principles  as  should 


13 

constitute  the  basis  of  every  philosophical  inquiry. 

In  mathematics,  you  cannot  rightfully  seek,  much  less  con> 
mand,  a  demonstration  without  a  suitable  basis  of  established  facts 
or  admitted  axioms.  So,  every  legitimate  argument  and  philosoph- 
ical investigation  should  rest  upon  facts  and  principles  that  are  ca- 
pable of  application  under  like  circumstances  in  every  process  of 
reasoning  by  which  the  inquiring  mind  desires  to  establish  truth. 
But  tor  the  very  reason  that  like  circumstances  are  absolutely  nec- 
essary for  the  proper  display  of  these  prerogative  facts  and  princi- 
ples, it  is  obviously  the  case,  that  they  are  inapplicable  in  any  rea- 
soning or  argument  by  which  it  may  be  attempted  to  account  for 
the  same  phenomena  under  dissimilar  ones. 

This  statement  comprises  the  theory  of  induction,  and  if  medi- 
cine be  entitled  to  a  place  among  the  inductive  sciences,  then  is  the 
principle  here  laid  down  of  importance  to  our  inquiry  ;  for,  as  every 
investigation  of  natural  phenomena  necessarily  becomes  an  inquiry 
into  causes  and  their  effects,  and  unavoidably  leads  to  a  series  of 
physical  laws,  so  every  well-grounded  theory  of  causation  must 
have  an  intimate  connection  with  the  theory  of  induction,  as  prac- 
tised in  the  natural  sciences.  Induction,  then,  gives  us  the  right 
to  expect  that  the  same  result  will  always  happen  from  the  same 
cause,  operating  under  like  circumstances  ;  but  it  is  of  the  very  es- 
sence of  this  inference  that  the  similarity  be  first  shown.  Without 
it,  no  process  of  induction  can  be  brought  to  a  lawful  conclusion, 
and  reason,  right  reason,  cannot  be  the  ground  of  our  belief.  More- 
over, upon  what  does  our  idea  of  causation  rest?  Unquestionably, 
the  uniform  observance  of  two  facts  or  sequences  of  external 
nature  furnishes  us  the  only  evidence,  a  priori,  of  causes  in  that 
sphere.  The  conjunction,  therefore,  of  any  two  successive  events 
may  very  properly  become  the  ground  ot  our  belief  in  their  relation- 
ship as  cause  and  effect,  provided,  the  second  event  has  always  been 
found  not  only  to  follow  the  first,  but  the  second  must  never  have 
been  observed  without  the  first  preceding  it. 

Mill,  in  his  admirable  treatise  on  causation,  defines  "  the 
cause  of  a  phenomenon  to  be  the  antecedent  or  concurrence  of  an- 
tecedents upon  which  it  is  invariably  and  unconditionally  conse- 
quent." And  again  ;  "  Invariable  sequence,  therefore,  is  not  sy- 
nonymous with  causation,  unless  the  sequence,  besides  being  invari- 
able, is  unconditional." 

Inconsiderately  viewed,  this  absolute  law  of  causation,  whose 


14 

property  and  requirements  are  not  only  invariable  uniformity,  but 
unconditional  consequence,  might  appear  to  shackle  our  experimen- 
tal inquiries  by  narrowing  down  the  proof  too  rigidly  ;  but  a  mo- 
ment's reflection  will  satisfy  us  that  such  is  not  the  case,  as  the  con- 
stituent  elements  of  a  law  in  the  science  of  physical  etiology,  the 
subject  under  inquiry,  ought  not  to  differ  from  those  of  a  law  in  the 
physical  sciences  generally — that  is,  so  far  as  the  analysis  has  ref- 
erence to  the  constancy  of  a  phenomenon,  or  the  invariableness  of  a 
relationship.  For,  let  it  be  remembered  that  we  are  investigating 
natural  phenomena  and  that  every  such  inquiry  is  a  search  after 
causes  and  effects,  and  not  a  study  of  the  calculus  of  probabilities, 
whose  loose  and  too  hasty  system  of  generalization,  attempting  to 
define  the  complex  before  the  simple  is  faithfully  learned,  has  led 
medical  minds,  loaded  with  hypotheses,  into  endless  vagaries  and 
absurdities  in  their  speculations  upon  the  subjects  of  practical  eti- 
ology. Recollect,  too,  that  nature  in  her  course  is  always  uniform 
and  certain,  and  that  her  order  and  economy  are  such  as  never  to 
employ  the  wasteful  expenditure  of  two  separate  and  distinct  caus- 
es to  accomplish  one  and  the  same  object,  although  in  a  series  of 
events  some  one  leading  phenomenon  may  be  the  chief  cause  of 
many  consequences,  and  it  will  be  clearly  seen  that  these  princi- 
ples are  not  too  rigid  for  a  correct  philosophy. 

Now  let  us  apply  this  Baconian  process  of  inductive  reason- 
ing, this  well  established  method  of  conducting  philosophical  in- 
vestigations, to  our  belief  in  the  miasmatic  origin  of  malarious  dis- 
eases, and  see  if  it  is  well  founded.  Or  whether,  in  the  first  place, 
we  have  not  assumed  a  fact,  which  is  not  proved,  and  then  built 
upon  it  a  theory,  which,  in  the  next  place,  we  are  prone  to  apply  when 
no  induction  or  proper  plan  of  philosophizing  shows  that  it  is  ap- 
plicable; thus  making  the  whole  operation  not  a  process  of  infer- 
ence or  induction,  but  one  of  interpretation  or  deduction,  which  is, 
after  all,  the  old  Syllogistic  method  of  teaching  by  authority,  rather 
than  according  to  the  rules  of  modern  philosophy,  which  has  dis- 
covered the  only  true  method  of  scientific  investigation,  by  making 
facts  the  basis  of  inductions.  To  take  these  constructive  formulas 
or  syllogysms  for  the  realities  of  experience  and  observation  was 
the  grand  folly  of  the  ancients.  To  employ  them  without  due  ex- 
amination as  to  their  real  value  and  scientific  applicability  is  the  be- 
setting pedantry  of  many  moderns,  especially  wrangling  theologi- 
ans, who  attempt  to  make  the   wisdom  and  laws  of  Omnipotence 


15 

quadrate  with  their  finite  notions  and  preconceived  opinions.  Care- 
fully investigated  then,  I  think  it  will  be  clearly  seen  that  medical 
men  have  been  reasoning  backwards,  as  it  were,  upon  this  subject 
of  miasm,  and  that  too  without  sufficient  data  to  conduct  them  to 
a  legitimate  conclusion,  whilst  the  rules  of  a  just  and  well  grounded 
philosophy  require  of  them  not  only  to  prove,  first,  the  existence 
of  the  facts  of  the  case,  and  their  invariable  relationships,  but  sec- 
ondly, that  they  shall  not  reason  from  such  facts,  in  an  explanation 
of  any  phenonmena,  excepting  under  like  circumstances 

It  might  be  well  worth  my  while  to  dwell  longer  upon  this 
important  principle,  if  I  had  the  time,  instead  of  apologising  for  the 
length  of  this  preliminary  discussion,  as  the  neglect  of  it  is  an  error 
very  generally  prevailing  with  medical  men,  as  well  as  others,  and 
one  which  leads  to  an  exceedingly  loose  and  careless  kind  of  inqui- 
ry; but  I  must  pass  on  to  the  consideration  of  my  subject  more  in 
detail,  trusting  that  the  array  of  facts  and  lawful  inferences,  which 
I  shall  adduce  in  support  of  my  position,  will,  at  least,  awaken  the 
spirit  of  inquiry  in  your  minds,  if  they  do  not  satisfy  you  of  its  en- 
tire correctness. 

But  for  the  purpose  of  doing  this  in  a  somewhat  systematic 
manner,  it  will  be  necessary  for  me  to  state  clearly,  first,  what  is 
understood  by  the  word  miasm  or  miasmata  in  the  sense  in  which 
it  is  used  by  those  who  invoke  its  aid  in  the  causation  of  diseases  ; 
and  secondly,  to  demonstrate  the  fallacy  of  the  doctrine,  by  show- 
ing ice  have  no  satisfactory  'proof  that  the  morbific  cause  of  what 
are  called  miasmatic  diseases,  arises  from  vegetable  putrefaction. 

Under  the  first  head,  I  shall  make  a  few  pertinent  extracts 
from  different  authors,  to  show  the  sense  in  which  the  word  miasm 
or  miasmata  is  used,  and  what  is  understood  by  them  to  be  the 
source  of  this  febrific  agent.  These  might  be  multiplied  without 
number,  but  as  there  does  not  prevail  much  difference  of  opinion 
among  the  miasmatists  upon  this  subject,  it  is  quite  unnecessary. 

Bancroft  informs  us  that  a  humid  soil  abounding  in  vegeta- 
ble remains,  and  acted  on  by  heat,  the  range  of  which  is  from  45 
to  100  Fahrenheit,  is  the  most  favorable  for  the  extrication  of  mias- 
mata. 

Dr.  Charles  Caldwell,  of  Transylvania  University,  in  a 
prize  essay  upon  the  subject  of  miasm,  expresses  the  following  opin- 
ion as  to  the  disease  producing  properties  of  decomposing  vegetable 
matter:  "Is  the  city  commercial,  and  situated  on  navigable  water  1 


16 

Let  not  the  wharves  be  built  entirely  of  wood.  Their  facing,  at  least, 
should  consist  of  stone  or  brick,  else  they  will  become,  in  time, 
masses  of  dissolving  vegetable  matter,  and  abundant  sources  of 
febrile  miasm.  That  the  cities  in  the  United  States  suffer  in 
their  health  from  this  cause,  cannot  be  doubted.  Piles  of  decaying 
timber,  alternately  wet  and  dry,  and  exposed  to  the  ardor  of  an 
American  summer  sun,  must  produce  malaria  as  certainly  and  as 
naturally  as  the  influence  of  spring  promotes  vegetation,  and  the 
rigors  of  winter  suspend  it." 

Dr.  Eberle,  article  miasmata,  assures  us  that  "Wherever  vegeta 
ble  matter  meets  with  sufficient  heat  and  moisture  to  cause  it  to  enter 
into  humid  decomposition,  there  miasmata  will  be  evolved,  &c. 

Clymer, in  his  "treatise  on  fevers,"  declares  "Whatever  its 
constitution  or  essence  maybe,  it  at  any  rate  appears  evident,  that 
in  order  to  its  production,  there  must  be  present  a  certain  quantity 
of  moisture,  vegetable  matter  in  a  state  of  decomposition,  and  a 
warm  temperature." 

Professor  Wood,  of  the  University  of  Pennsylvania,  in  his 
work  on  the  practice  of  medicine,  article  miasma,  observes  that,  "So 
strong  indeed,  is  the  evidence  of  this  fact,  that  the  great  mass  of  ob- 
servers, ever  since  the  time  of  Lancisi,  have  agreed  and  still  agree, 
in  ascribing  the  miasmatic  influence,  whatever  may  be  its  nature, 
to  organic  and  especially  vegetable  decomposition." 

Agreeably  to  Elliotston,  a  distinguished  practitioner  of  London, 
"The  exciting  cause  of  ague,  the  true  indispensable  cause  of  it,  I  be- 
lieve to  be  an  exhalation  from  decaying  vegetable  matter,"  and  that 
"a  certain  degree  of  moisture  is  necessary  for  the  fermentation  and 
putrefaction  of  vegetable  matter,which  fermentation  and  putrefaction 
give  rise  to  the  exhalations  which  produce  ague."  Whilst  Mc- 
Cullock,  who  stands  at  the  head  of  the  miasmatists,  in  his 
treatise  on  malaria,  arrives  at  the  opinion,  "That  the  presence 
of  vegetables  or  vegetable  matter  in  some  mode  or  form,  is  necessa- 
ry to  the  extrication  of  malaria;  while  the  conclusion  has  some- 
times been,  that  it  is  a  production  formed  between  the  living  veget- 
able and  water  ;  more  generally  that  it  is  generated  between  that 
and  the  latter,  in  some  stage  intermediate  between  life  and  absolute 
decomposition,  or  lastly,  that  it  is  the  eonsequence  of  absolute  pu- 
trefaction." 

From  the  above  extracts,  which  have  been  selected  without 
much  care,  it  will  be  seen  that  miasm  consists  mainly,  if  not  entire- 


17 

Iy,  of  an  exhalation  from  decomposing  vegetable  matter,  under  such 
circumstances  of  heat  and  moisture  as  are  capable  of  producing 
putrefaction. 

Now,  as  it  is  not  necessary  for  the  object  of  this  investigation 
that  I  should  stop  here  to  inquire  into  the  slight  differences  in  opin- 
ion amongst  the  miasmatists,  as  to  the  specific  amount  of  heat, 
moisture,  and  vegetable,  or  organic  matter,  which  it  is  necessary  to 
have  for  the  purpose  of  evolving  this  subtile  poison,  since  we  may 
very  naturally  conclude,  we  shall  have  the  greater  product,  the 
more  material  we  have  out  of  which  to  form  it,  I  shall  proceed  at 
once  to  show,  under  the  second  head,  by  extracts  from  the  most 
reliable  authors,  and  by  adducing  instances  of  undoubted  truth, 
that  we  have  miasmatic  diseases  prevaling  in  situations  so  totally 
different  from  each  other,  it  is  impossible,  under  the  rules  of  a  cor- 
rect philosophy,  to  ascribe  them  to  effluvia  from  decaying  vegetable 
matter.  In  other  words,  that  we  are  sometimes  exempt  from  them 
where  vegetation  and  decaying  vegetable  matter,  together  with  heat 
and  moisture,  sufficient  to  produce  putrefaction  are  abundant,  and 
then  again,  have  them  committing  fearful  ravages,  where  there  is 
no  vegetable  matter  to  decay,  and  where  there  is  no  moisture  to  aid 
putrefaction. 

Dr.  Drake,  in  his  work  on  the  principle  diseases  of  the  valley 
of  North  America,  speaking  of  the  Miami  valley,  says  :  "  The  up- 
per portions  of  this  basin  abound  in  wet  and  marshy  prairies,  wood- 
land swamps,  and  ponds,  or  small  lakes  of  pure  water.  The  Sou- 
thern portions  offer  but  little  of  either  on  the  uplands  ;  but  in  the 
wide  valleys  of  both  the  miamies  and  along  all  their  larger  tributa- 
ries every  variety  of  wet  surface  was  found  in  spring  and  early 
summer,  when  settlements  were  first  made :  by  clearing,  cultiva- 
tion and  draining,  however,  a  much  drier  condition  has  been  pro- 
duced. At  the  same  time,  mill-ponds  have  greatly  multiplied,  and 
two  canals,  one  from  Cincinnati  to  Dayton,  and  thence  to  Lake 
Erie,  and  the  other  from  the  former  city  to  Brookville,  and  Gam- 
bridge,  in  the  State  of  Indiana,  have  been  excavated.  In  the  month 
of  June,  they  are  annually  emptied  of  water,  and  the  mud  accumu- 
lated in  their  bottoms,  is  scraped  out  upon  their  banks."    *     *     * 

"  Through  the  whole  distance,  it  (the  canal  to  Dayton,)  traver- 
ses a  fertile  valley  from  one  to  three  miles  in  width,  abounding  in 
diluvial  terraces  and  low  alluvial  bottoms,  to  which  the  present  dim- 
inutive stream  bears  in  the  volume  of  its  waters  no  assignable  pro- 


is 

portions.  This  valley  is,  in  fact,  the  obsolete  bed  of  one  of  those 
vast  river  currents  which  once  flowed  from  the  north  into  the  trough 
of  the  Ohio  river." 

Here  we  unquestionably  have  an  abundance  of  the  materials, 
heat,  moisture  and  vegetable  matter,  for  the  generation  of  miasm  ; 
and  yet  the  same  writer  who  has  furnished  us  with  the  above  de- 
scription, declares,  "It  does  not  appear  that  the  inhabitants  of  the  re- 
gion through  which  the  canals  were  dug  were  injured  by  the  process, 
or  by  letting  in  the  water  when  they  were  finished  ;  nor  have  I  been 
able  to  collect  any  reliable  evidence,  that  the  annual  emptyings  and 
•cleanings  out,  have  been  productive  of  fever." 

Again,  on  the  authority  of  Dr.  Hentos,  he  assures  us,  there  is 
on  Paint  Creek,  in  Ohio,  a  mill  pond  covering  over  sixty  acres  oi 
bottom  land,  near  the  village  of  Washington,  which  is  generally 
drained  off  about  the  first  of  June,  after  having  been  submerged  all 
the  previous  autumn,  winter,  and  spring,  and  yet  it  was  never 
known  to  cause  sickness  in  the  neighborhood. 

Pensacola  bay  is  several  miles  in  extent,  and  bounded  On  the 
west  side,  from  the  Gulf  coast  up  to  its  head,  with  sand  beach  of  lim- 
ited extent,  in  the  midst  of  which  are  found  marshes  of  fresh  Water 
covered  with  cypress,  magnolia,  subaquatic  plants  and  shrubs,  yet 
it  is  quite  healthy,  excepting  near  the  head  of  the  bay,  where  the 
Escambia  river,  coming  down  from  Alabama,  empties.  Here  it 
has  been  notoriously  sickly  always,  notwithstanding  the  tempera- 
ture and  moisture  are  the  same,  as  they  are  lower  down  the  bay  and 
the  extent  of  marsh  only  a  trifle  greater. 

My  present  object  does  not  make  it  necessary  for  me  to  de- 
scribe particularly  the  topography  of  the  Delta  of  the  Mississippi^ 
further  than  to  state,  what  every  one  knows,  that  it  consist  of  allu- 
vial deposits,  with  an  abundant  and  luxuriant  vegetable  growth. — - 
Such  a  condition  of  things,  in  so  hot  a  climate,  might,  dpriori,  be 
claimed  by  the  miasmatist  as  the  very  focus  of  miasms ;  but  let  us 
see  what  are  the  opinions  of  some  distinguished  medical  gentlemen, 
themselves  believers  in  the  doctrine  of  the  miasmatic  origin  of  dis- 
ease, upon  this  subject. 

The  inhabitants  of  the  Balize,  writes  Dr.  Drake,  suffer 
much  less  from  miasmatic  diseases  than  those  who  reside  along 
the  rivers  of  the  interior  of  Louisiana,  notwithstanding  vegetation, 
heat,  and  moisture,  are  as  abundant  at  the  Balize  as  more  inland. — 
ThiSj  he  and  others  attempt  to  explain,  by  supposing  that  the  salt 


19 

water  of  the  Gulf  waves  prevents  the  extrication  of  miasmata  at  the 
Balize.  The  same  reason  is  given  for  the  comparative  healthful- 
nessof  Key  West ;  and  also  to  explain,  why  Port  Pike  is  less  liablo 
to  malarious  diseases  than  Fort  Wood;  but  it  will  be  seen  present- 
ly from  the  statements  of  Marci-ietti,  that  whatever  sanatary  prop- 
erties  salt  water  may  have  in  this  country,  under  such  circumstan- 
ces, it  has  no  such  virtues  in  Italy.  As  to  the  influence  of  salt  water 
in  preserving  the  health  of  marshy  places,  Marchettj,  in  his  med- 
ical topography  and  statistics  of  the  Tuscan  Maremma,  speaking  of 
the  cause  of  the  fever,  is  decidedly  of  opinion,  that  "the  mixture  of 
salt  with  fresh  water  greatly  increases  the  intensity  of  the  miasms, 
because  pestiferous  marshes  have  become  innocuous  as  soon  as  the 
ingress  of  salt  water  has  been  prevented."  He  gives  instances  of 
this  fact,  one  in  particular.  Near  Viareggeo,  a  nice  and  pleasant 
little  town  has  sprung  up  and  is  used  as  a  retreat,  or  watering  place, 
in  those  very  months  when  it  was  formerly,  or  before  the  salt  wa- 
ter was  shut  off  from  its  marshes,  almost  pestilential,  In  a  word 
he  insists  that  the  cause  of  fever  in.  the  Maremma  is  an  emanation 
from  decomposing  animal  matter  in  the  marshes,  and  that  the  "hu- 
midity of  the  atmosphere,  vegetable  decomposition,  and  changes  of 
temperaturej  are  only  auxilliaries,  as  these  conditions  are  to  be  found 
in  districts  not  subject  to  intermittant  and  remittant  fevers." 

Dr.  E?erle,  one  of  our  standard  writers  upon  such  subject s, 
confirms  this  statement  of  Marcpettj,  upon  the  opinion  of  Mon- 
falcon,  a.nd  his  own  observations.  He  says,  "A  mixture  of  fresh, 
and  sa,lt  water  in  marshes  appears  to  enhance  the  copiousness  and 
virulence  of  miasmata  to  a  very  obvious  degree.  "It  is  a  singular 
fact,"  says,  the  Doctor,  ''that  tne  water  of  the  sea  is  much  more  apt 
$o  enter  into  putrefactive  decomposition  than  freshwater  j  and  this, 
no  doubt,  depends  on  the  great  quantity  of  organic  matter  which  it 
contains." 

But  to  return  to,  the  delta  of  the  Mississippi.  Fort  Pike  is, 
thirty  five  miles  north-east  from  New  Orleans,  and  situated  on  the 
Island  of  Petites  Coquilles.  This  Island,  elevated  about  two  feet 
above  the  Gulf,  enjoys  a  rich  productive  soil,,  composed  of  shells,, 
argillacious  and  vegetable  matter.  It  is  washed  on  one  side  by  the 
waters  of  Pearl  river,  and  intersected  with  numerous  bayous  and 
marshes,  and  has  pools  of  stagnant  water,  but  notwithstanding  these- 
inviting  circumstances,  it  has  never  been  visited  by  yellow  fever,, 
and  autumnal  fevers  even,  are  very  scarce.* 

*Army  Statistical  Reports 


20 

Port  Wood  is  seven  miles  from  Fort  Pike,  and  situated  on  the 
south  side  of  the  channel,  Chef  Mentieur,  one  of  the  connecting 
Straits,  between  Lake  Ponchartrain  and  Lake  Borgne.  In  its  rear 
there  are  some  cypress  and  fresh  water  swamps  of  limited  extent, 
which  are  annually  replenished  by  rains  with  fresh  water,  like  the 
same  character  of  swamp  and  marsh  in  the  rear  of  the  "  coasts," 
from  New  Orleans  to  Bayous  La  Fourche  and  Plaquemine.  This 
situation  is  decidedly  insalubrious,  according  to  the  same  authority, 
A.  S.  Reports,  which  makes  Fort  Pike  comparatively  healthy  ;  and 
Dr.  Drake  and  others  endeavor  to  account  for  the  difference,  by 
the  presence  of  salt  water  in  the  swamps  of  the  last  mentioned 
place.  The  insufficiency  of  this  explanation,  I  have  already  denied 
upon  competent  authority,  but  even  if  it  were  true,  the  difficulty 
would  still  remain  of  accounting  for  the  healthiness  of  the  "  coasts," 
as  they  are  called,  or  banks  of  the  Mississippi,  from  New  Orleans  to 
the  outlets  of  Bayous  La  Fourche  and  Plaquemine,  which  the 
swamps  and  marshes  about  Fort  Wood  closely  resemble,  and 
which  Dr.  Drake  assures  us,  are  peculiarly  exempt  from  autumn- 
al diseases. 

Dr.  Cartwright,  a  gentleman  of  great  distinction,  in  an  ar- 
ticle in  the  Western  Journal  ot  Medicine  and  Surgery,  Vol.  1.,  is 
reduced  to  the  necessity  of  attributing  health  preserving  properties 
to  the  water  lily,  (Jussieua  Grandiflora,)  to  save  himself  from  the 
confession  that  there  is  no  truth  in  the  miasmatic  hypothesis.  He 
says  :  "  The  country  immediately  north  of  the  line  bounding  the 
growth  of  the  floating  plant,  (which  is  about  the  30  deg.  north  lat- 
itude,) like  that  south  of  the  30  deg.,  is  alluvial,  contains  lakes, 
swamps,  and  stagnant  water,  is  covered  with  nearly  the  same  veg- 
etable productions  ;  but  its  atmosphere  is  evidently  insalubrious, 
it  stagnant  waters  impure,  its  inhabitants  sickly,  and  human  life  of 
short  duration,  while  the  country  of  the  aquatic  plant,  immediately 
south  of  it,  contains  a  wholesome  atmosphere,  pure  water,  healthy 
and  long  lived  inhabitants."  In  some  situations,  within  the  region 
of  the  floating  plant,  where  the  Doctor  thought  if  the  country  con- 
tained sickly  spots  anywhere,  they  richly  deserved  to  be  so  consid- 
ered, he  found  the  inhabitants  altogether  exempt  from  autumnal 
diseases. 

In  regard  to  the  value,  however,  of  this  theory  of  Dr.  Cart- 
wright,  Dr.  Drake  remarks,  that  "it  is  at  least  an  open  question,  as 
the  "coasts,"  or  banks  of  the  Mississippi,  from  New  Orleans  to  the 


21 

outlets  of  Bayou  Plaquemine  and  Bayou  La  Fourclie,  lying  nearly 
north  of  the  region  of  Jussieua  Grandiflora,  are  equally  free  from 
autumnal  diseases  and  contains  as  many  aged  inhabitants." 

Here,  then,  we  have,  confessedly  an  ample  supply  of  all  the  materials 
required  by  themiasmatists  for  the  manufacture  of  malaria ;  but,  in- 
deed, the  country  seems  to  be  so  singularly  and  unexpectedly  ex- 
empt from  miasmatic  diseases,  that  every  one  is  looking  out  for 
some  countervailing  agency,  some  means  of  neutralizing  the  marsh 
poison,  which  each  believes  must  be  generated  under  circumstances 
so  favorable  for  its  evolution.  Each  learned  Doctor  has  lus  own 
peculiar  views  upon  the  subject,  whilst  the  common  people  gen- 
erally say  it  is  owing-  to  the  prevalence  of  sea  breezes  ;  but  why  do 
not  the  sea  breezes,  felt  with  equal  force  and  constancy  at  the  head 
of  Pensacola  bay,  where  the  Escambia  river  empties,  and  where 
there  is  one  little  marsh  of  some  one  or  two  miles  in  extent,  instead 
of  a  whole  region  of  marshes,  preserve  that  locality  from  the  repu- 
tation of  being  one  of  the  most  insalubrious  spots  on  the  face  of  the 
earth.* 

So,  likewise,  in  our  own  State,  we  have  extensive  tracts  of 
swamp  land,  in  which  a  great  number  of  laborers  are  engaged  ev- 
ery year  in  getting  shingles.  These  laborers,  not  only  work  dur- 
ing the  day  in  these  swamps,  and  drink  swamp  water,  which  is 
greatly  discolored  by  decaying  vegetable  matter,  but  sleep  in  them 
at  night,  in  open  huts  or  rudely  constructed  shantees  ;  yet  they  are 
decidedly  the  healthiest  portion  of  the  laboring  classes  in  those 
parts  of  the  State.  Now,  this  cannot  be  owing,  as  some  pretend  10 
believe,  to  the  iact,  that  as  the  swamps  are  not  entirely  cleared  and 
drained,  vegetable  decomposition  does  not  take  place,  because  that 
is  palpably  an  error.  Our  own  senses  teach  us  such  is  not  the  case, 
and  that  vegetable  decomposition  does  take  place  to  an  enormous 
extent.  The  whole  superstratum,  which  is  oftentimes  many  feet  in 
thickness,  consists  of  the  debris  of  vegetable  and  animal  matter  ; 
for  these  swamps  are  scarcely  more  noted  for  their  luxuriant  vege- 
tation, than  they  are  for  their  abundance  of  insects  and  reptiles. 
Besides,  I  am  informed  by  Mr.  Redding  L.  Myers,  a  respectable 
gentleman  of  the  town  of  Washington,  who,  as  assistant  engineer, 
had  charge,  in  part,  of  theworkmen  employed  upon  the  public  lands 
about  PungoLake,  that  they  were  remarkably  healthy  Here,  an  ex- 
tensive and  systematic  plan  of  drainage,  by  canaling  and  ditching, 
exposed  the  laborers  10  the  exhalations  from  the  soil,  under  a  variety 

*  Lind  and  others. 


22 

of  circumstances,  as  well  upon  the  prairie  marshes,  as  in  the  open 
swamps  and  close  jungles;  and  yet  ihey  scarcely  had  any  fever 
amongst  them,  or  required  the  attentions  of  a  physician,  during  the 
two  or  three  years  they  were  engaged  in  this  service. 

The  Antilles,  Brazil,  East  Indias,  Europe,  and  other  parts  of 
the  earth,  furnish  us  examples  of  the  same  kind.  British  Guiana, 
with  its  wet  and  dry  seasons,  and  extensive  alluvial  marshes,  which 
have  been  reclaimed  from  the  sea  by  a  most  expensive  and  perma- 
nent system  of  diking,  together  with  its  culture  of  Sugar.  Rice,  In- 
digo, &c,  is  represented  by  a  writer  in  the  British  and  Foreign 
Medico-chh'urgical  Review  for  1850,  as  "among  the  most  healthy 
of  the  West  Indian  Colonies,  and  capable  of  being  healthfully  ten- 
anted by  European  residents/' notwithstanding  "its  wide  alluvial, 
tiaets." 

Furgerson  says  °"The  town  of  New  Amsterdam,  Berbice,  is 
situated  within  short  musljet  shot  to  leeward  of  a  most  offensive 
swamp,  in  the  direct  tract  of  a  strong  tradewind  that  bjows  night 
and  day,  and  frequently  pollutes  even  the  sleeping  apartments  of 
the  inhabitants,  with  the  stench  of  the  swamps  ;  yet  it  had  produced 
no  endemic  fever  worthy  ot  notice,  even  among  the  newly  arrived, 
for  a  period  of  years  previously  to  my  visiting  that  colony." 

The  town  of  Kingston,  in  the  Island  of  St.  Vincent,  is  so  situ- 
ated, says  Report  Armstrong,  "as  to  have  all  the  elements  necessary 
for  the  production  of  this  vegeto-animal  poison,  heat,  moisture,  de- 
cayed and  decaying  vegetable  matter,  with  as  large  a  proportion  of; 
reptiles,  insects  and  other  animal  matter  as  is  found  in  other  tropical 
countries ;  yet  strange  to  say,  the  town  of  Kingston  is  one  of  thj 
most  healthy  spots  in  the  West  Indias.  I  was  informed  by  the 
staff  surgeon  to  the  forces,  who  had  long  resided  there,  that  it  ivqs. 
as  healthy  as  the  most  favorable  spot  in  England. 

Brazil,  too,  is  said  to  be  entirely  exempt  from  endemics,  al- 
though it  has  an  extremely  fertile  soil,  a  sultry  atmosphere,  and  a 
most  magnificent  profusion  of  vegetation  of  almost  endless  variety. 
This  vast  empire  is  intersected  everywhere  with  navigable  streams, 
which  pour  their  waters  through  a  common  mouth  into  the  Ocean, 
and  indented  along  its  sea  coast,  of  more  than  two  thousand  miles. 
in  extent,  with  numerous  beautiful  and  safe  harbors.  The  Delta 
of  the  Amazon  alone  spreads  along  the  Atlantic  shore,  on  either  side 
of  the  equator,  to  the  breadth  of  one  hundred  and  fifty  miles,  and  its 
length  from  the  ocean  to  the  fartherest  point  where  the  ebbing  and 


flowing  of  the  regular  tides  are  felt,  and  where  the  innumerable 
Islands  and  labyrinth  of  channels  begin,  is  over  six  hundred  miles. 
The  intelligent  American  travellers.  Kidder  and  Edwards,  spent 
several  years  in  this  country,  and  concur  m  representing  every  por- 
tion of  it,  even  the  entire  valley  of  the  Amazon,  embracing  nearly 
one  half  of  this  vast  territory,  as  salubrious  in  a  remarkable  degree. 
The  latter,  Edwards,  says  he  never  saw  but  one  case  of  Intermit- 
tent during  the  three  years  he  remained  in  the  country,  and  that, 
he  cured  with  a  single  dose  of  medicine. 

Dr.  Horner,  of  the  U.  S.  Navy,  in  describing  the  topography 
of  the  city  of  Rio  Janeiro,  says :  u  The  proximity  of  the  Oceanj  the 
great  size  of  the  harbor,  the  great  height  of  the  land  about  it^  the 
many  hills,  narrow  streets,  and  high  temperature,  keep  Rio  almost 
without  cessation  immersed  in  a  heavy,  sultry  atmosphere,  render- 
ed nib  re  disagreeable  by  want  of  cleanliness  and  the  exhalations 
from  the  ravines  and  marshy  grounds  in  its  rear" — yet  Rio,  not- 
withstanding, is  considered  by  travellers  generally,  who  have  spent 
some  time  there,  as  well  as  in  other  parts  of  Brazil,  to  be  healthy. 
And  Walsh  informs  us  that  for  many  weeks  at  a  time,  during  the 
rainy  season,  there  were  several  hours  in  each  day  when  his  clothes 
would  be  wet  on  hiim  and  that  he  oftentimes  put  oh  wet  clothes  in 
the  morning,  which  had  remained  wet  all  night ;  and  that  whenever 
the  sun  shone  out,  it  was  so  intensely  hot,  that  he  went  smoking 
along  in  his  wet  clothes,  the  water  from  which  was  exhaling  by 
heat  and  dissolving  into  vapor.  "  Such  weather,"  to  use  his  own 
language,  "in  Africa,  under  the  same  latitude,  no  human  being 
could  bear  ;  but  not  so  in  Brazil ;  no  one  is  affected  by  those  states 
of  the  atmosphere  which  are  so  fatal  elsewhere.  It  lias  with  some 
reason,  therefore,  grown  into  a  proveb,  that  it  is  a  country  where  a 
physician  cannot  live,  and  yet  where  he  never  dies/' 

New  South  Wales,  including  South  Australia,  and  Australia  Felixr 
has  a  wet  and  dry  season,  an  abundance  of  streams,  bays,  estuaries, 
swamps  and  ponds  of  stagnant  water,  and  in  some  places,  particu- 
larly about  its  towns,  a  rich  and  highly  productive  soil.  It  is  like- 
wise subject  to  inundations  from  the  rivers,  and  its  alluvial  swamps 
to  overflows  from  the  sea  ;  yet  notwithstanding  all  these  indica- 
tions of  a  sickly  climate.  New  South  Wales  is  exceedingly  healthy 
and  free  from  endemics.* 

"The  Island  of  Java"  says,  Sir  Stanford  Raffles,  one  oi 
the  lieutenant  Governors  of  that  Island  and  its  dependencies;  "stands 

s  Malte  Brun  and  Byrne. 


24 

on  a  level,  in  point  of  salubrity,  with  the  very  healthiest  parts  of 
British  India,  or  any  tropical  country  in  the  world,  although  it  a- 
bouuds  in  a  most  luxuriant  vegetation,  and  in  numberless  streams 
cataracts  and  rivulets,  which  are  tamed  to  the  peasants  will.  In 
the  hottest  and  driest  season,  they  are  made  to  retain  some  of  their 
water,  which  the  farmer  directs  into  endless  conduits  and  canals  to 
irrigate!  the  lands,  which  he  has  laid  in  terraces  for  its  reception. 
It  thence  descends  to  the  plains  and  spreads  over  them  shedding 
fertility  whereever  it  flows,  till  at  last,  by  innumerable  outlets  it 
discharges  itself  into  the  sea." 

This  same  system  of  artificial  irrigation,  which  is  so  innocuous 
in  Java,  is  beleived  by  Dr.  Wilson,  in  his  medical  notes  on  China, 
to  be  the  cause  of  the  unheal fhiness  of  the  Islands  of  Chusan  and 
Hong  Kong  :  for  he  says,  "The  meteoric  influences  and  the  aspect 
of  the  country  appear  highly  favorable  to  health — what  is  detrimen- 
tal is  believed  to  be  chiefly  the  wilful  work  of  man's  hands,  or  of 
perverse  ignorance." 

Mr.  Peale,  the  Geologist  to  the  exploring  expedition,  under 
Capt.  Wilkes,  in  a  letter  to  Dr.  Dungleson,  published  in  the  Med- 
ical Examiner  for  1843,  states,  that  they  visited  situations  in  the 
course  of  their  travels  amongst  the  Friendly,  Society,  Fegee,  Sam- 
oan  and  Sandwich  Islands,  where  the  inhabitants  subsisted,  in  part, 
upon  the  root  of  the  Tarro  plant,  which  requires  to  be  cultivated, 
like  our  rice,  in  shallow  fresh  water  ponds  and  marshes,  and  where 
natural  marshes  do  not  occur,  they  are  artificially  constructed  by 
the  natives.  He  states  further,  that  they  often  found  their  towns 
situated  in  the  midst  of  these  "Tarro  patches,"  which  plentifully 
supplied  the  residences  with  musquitoes  and  other  inseets,  and  the 
stench  of  the  marshes;  yet  neither  the  officers,  nor  men,  nor  the 
scientic  corps,  suffered  in  consequence  of  their  exposure  although 
they  were  in  the  midst  of  the  exhalations  from  these  marshes  day 
and  night,  living  and  sleeping,  owing  to  "the  shore  duties  of  the 
service,  in  the  midst  of  marsh  stenches  and  musquitoes,  when  the 
days  were  hot,  and   the  huts  open  and  exposed." 

Capt.  Wilkes  mentions  that  these  Islands  are  hot,  moist,  fertile, 
and  remarkably  healthy. 

On  the  other  hand,  Mr.  Peale  observes  that  almost  every  one  of 
the  expedition,  suffered  more  or  less  from  endemic  diseases,  after  their 
arrival  on  our  north-west  coast,  and  had  encamped  upon  the  Wal- 
lametle  river,  in  Oregon,  where  there  were  no  marshy  gronnds,  ex- 


25 

cessive  moisture,  stagnant  ponds,  or  other  sources  of  miasm,  as  both 
the  earth  and  the  atmosphere  were  remarkably  dry. 

Dr.  Hope,  of  Princeton,  in  a  letter  to  Prof.  J.  K.  Mitchell, 
of  Philadelphia,  describes  the  Island  of  Singapore,  which  lies  with- 
in the  tropics,  and  abounds  in  streams,  marshes,  ponds  and  pools  of 
stagnant  water,  with  its  jungles  and  a  most  luxuriant  vegetation  in 
many  places,  of  astonishingly  rapid  growth,  and  equally  rapid  decay, 
as  being  very  rarely  visited  by  fevers  of  any  kind,  and  when  they 
did  occur,  were  from  "imprudent  exposure  to  fatigue  or  the  sun." 
"Singapore,"  says  the  Doctor,  "is  considered  a  kind  of  Sanatarium. 
for  the  oriental  invalids,  who  go  thither,  from  every  quarter  of  the 
eastern  world,  to  escape  from  malaria  or  to  recover  from  chronic 
diseases." 

In  Ireland,  emphatically  a  country  of  swamps,  bogs  and  ponds, 
the  inhabitants  in  the  linen  manufacturing  districts  rot  their  flax 
in  dead  water  ponds  and  ditches,  thus  filling  the  whole  atmosphere 
with  the  effluvia  from  this  mass  of  decomposing  vegetable  matter; 
yet,  Ireland,  even  under  such  favorable  circumstances  for  the  pro- 
duction of  miasmata,  is  not  subject  to  endemics  of  intermittent 
and  remittent  fevers. 

Dr.  Bell,  in  an  article  "  On  miasm  as  an  alleged  cause  of  fe- 
vers," in  the  llth  vol.  of  the  Philadelphia  Medical  Journal,  says: 
"  The  inhabitants  of  every  Dutch  house,  ought,  from  the  above 
creed,  to  be  attacked  annually  with  intermittent  fevers,  since  to 
each  is  attached  a  summer  house,  situated  immediately  over  a  small 
stagnant  canal,  covered  with  vegetable  remains,  and  exposed  to  the 
sun's  rays.  Here,  hours,  especially  in  the  evening,  are  spent  by 
the  family,  without  the  members  of  it  being  afflicted  with  disease." 

Siou,  or  what  is  called  the  "  Jews'  Quarter"  in  Rome,  is  rep- 
resented by  Dr.  James  Johnson,  in  his  work  on  change  of  air,  as 
the  dirtiest,  filthiest,  dampest,  "  and  the  healthiest  spot  in  that 
famous  city.''''  Being  down  upon  the  shores  of  the  Tiber,  and 
more  exposed  to  the  vapors  from  the  river,  and  wet  river  banks, 
than  any  other  portion  of  the  Roman  Capital,  it  ought  to  be  sickly 
according  to  the  views  of  the  miasmatists,  but  "  it  is  quite  free  from 
the  fatal  malaria.'' 

So,  Lisbon,  one  of  the  filthiest  towns  in  all  Europe,  cannot 

carry  on  gardening,  which,  in  so  dry  a  country,  is  of  the  utmost 

importance  to  every  family,  without  artificial  irrigation,  and  that 

the  inhabitants  may  be  able  to  accomplish  this  desirable  purpose, 

4 


26 

the  Water  is  collected  during  the  rainy  season  in  the  cisterns  in 
their  gardens,  and  under  their  houses.  The  water,  says  Fergu- 
son, being  of  utmost  importance,  is  husbanded  carefully,  for  sever- 
al months  in  the  dry  season.  Diminishing  daily  by  drainage  and 
evaporation,  it,  of  course,  gets  into  a  most  concentrated  state  of 
foulness  and  putridity,  with  a  thick  green  vegetable  scum  upon  it ; 
yet,  no  one- ever  dreamed  of  its  producing  fever,  although  the  most 
ignorant  native  is  well  aware,  that  were  he  to  cross  the  river,  and 
sleep  on  the  shores  of  the  Alentejo,  where  a  particle  of  water,  at 
that  season,  had  not  been  seen  for  months,  and  where  water,  being 
absorbed  into  the  sand  as  soon  as  it  fell,  was  never  known  to  be  pu- 
trid, he  would  run  the  greatest  risk  of  being  seized  with  remittent 
fever."*  The  same  author  gives  us  another  example  of  a  somewhat 
similar  nature.  "  In  the  West  India  Sugar  Ships,"  he  observes, 
"  the  drainage  of  the  Sugar,  mixed  with  the  bilge  water  of  the  hold, 
creates  a  stench  that  is  absolutely  suffocating  to  those  unaccustomed 
to  it,  yet  it  is  denied  that  malaria  or  malarious  diseases  are  genera- 
ted even  from  this  combination." 

So  the  water  of  the  Thames,  according  to  Dr.  Dun&lison, 
loaded  with  all  the  filth  and  soluble  materials,  animal  and  vegeta- 
ble, which  it  acquires  in  its  course  to  the  sea,  is  nevertheless  the 
best  water  to  take  on  a  long  voyage  ;  for  having  undergone  a  pro- 
cess of  fermentation,  or  self  purification,  it  keeps  sweet  and  potable 
a  great  while.  Accordingly,  merchantmen  and  ships  of  war  fill 
with  it  their  water  tanks,  which  are  situated  immediately  under 
the  hammocks  and  berths  of  the  men.  Now,  during  the  fermenta- 
tion of  the  water,  which  takes  place  after  a  little  while,  the  sleep- 
ing apartments,  and,  indeed,  all  portions  of  the  ship,  are  filled  with 
an  almost  intolerable  stench  ;  yet  it  never  produces  disease. 

I  shall  now  call  your  attention  to  another  class  of  facts.  In 
Guinea,  according  to  Lind  and  other  writers,  during  the  entire 
period  of  continued  heat  and  drought,  which  sometimes  lasts  for  six 
or  eight  months,  when  every  thing  is  parched  up,  and  the  earth  is 
literally  baked  and  cracked  open  in  great  fissures,  and  the  rivers 
dried  up,  or  restricted  to  very  narrow  channels,  leaving  a  large 
portion  of  their  alluvial  beds  and  slimy  mud  banks  exposed  to  the 
rays  of  a  burning  sun,  there  is  no  disease.  But  when  the  rains 
have  set  in,  and  the  parched  earth  is  soaked  with  water,  and  the 
rivers  begin  to  fill  up,   diseases  become  rife  and  the  mortality  is 


great, 


'Article  on  Marsh  Poison.  &.c« 


27 

Egypt,  too,  which  is  inundated  or  partially  covered  by  the  o- 
verflowing  waters  of  the  Nile  for  nearly   three-fourths  of  the  year, 
and  which  has   its  atmosphere   filled  with   the  exhalations  from 
stagnant  lakes,  canals  and   pools,  and  the  drying  up  of  its  deep  al- 
luvial soil  by  the  action  of  a  powerful  sun,  producing  an  excessive 
evaporation,  enjoys  freedom  from  endemics  of  intermittent  and  remit- 
tent diseases  ;  and,  indeed,  since  the  days  of  the  celebrated  Yolney, 
travellers  generally  have   agreed  that  its  climate  was  salubrious — ■ 
much  more  so  than  Cypress  and   other  parts  of  the  Levant,  less  a- 
bundantly  furnished  with  the  supposed  sources  of  miasm.     Let  us 
Cake  a  single  example  of  this  fact.    Menouf,  the  capital  of  one  of  the 
provinces  of  lower  Egypt,  although  its   south   and  west  walls   are 
situated  on  the  banks  of  a  very  shallow  canal,  and  near  to  another 
still  shallower,  neither  being  navigable,  and   the   latter  consisting 
.chiefly  of  stagnant  pools,  is,  notwithstanding,  a  remarkably  healthy 
place.     Besides  these  canals,  there  are,  in  the  immediate  neighbor- 
hood of  the  town,  ponds  of  dead  water  in  which  the  inhabitants  rot 
•their  fax,  with  here  and  there  a  burying   ground,  which  is  over- 
flowed by  the  high  waters  from  the  Nile  ;  but  as  the   waters   do 
not  remain  on  the  lands  about  Menouf  as  long  as  they  do  over  most 
other  parts  of  the  delta,  Surgeon  Carrie   thinks  this  may  be  the 
reason  of  its  extreme  healthiness.     So,  in  our   own  State,   on   the 
lower  Roanoke,  where  the  bottom  lands  are  guarded  from  the  river 
inundations  by  diking,  in  August  last,  owing  to  a  very  unusual  rise 
in  the  river,  the  levees  gave  way  in  many  places,  and  large  farms 
and  extensive  tracts  of  land,  heretofore  protected  against  such  inun- 
dations, were  overflowed.     When   this  disastrous  rise  in  the   river 
occurred,  the  farms  were  covered    with   luxuriant   growing  crops, 
and  an  abundance  of  vegetable   matter,  in   a  succulent  state,  occu- 
pied the  bottom  lands  and  marshes.     In  many  places,  all  this  mass 
of  vegetable  matter  was  destroyed   entirely,  and   left,  by  the  subsi- 
dence of  the  flood.,  to  putrefy  upon  the  land,  filling  the  whole  air 
with  its  stench,  whilst  the  earth's  surface,  by  excessive  evaporation, 
during   an  unusually  warm  and   long  autumn,   became  perfectly 
dry  and  even  baked,  cracking   open  in  many  places  with  long  and 
deep  fissures.     Such   was  particularly  the  case  with  regard  to  the 
bottom  lands  and  marshes  in  the  counties  of  Northampton,  Halifax 
and  Bertie;  and,  yet,  I  am  informed  by  gentlemen   of  high  intelli- 
gence and  standing,  part  owners  of  these  lands,  that  contrary  to  all 
expectation,  it  was  an  unusually  healthy  season. 


28 

.Such  a  state  of  dryness,  t  must  admit,  perhaps,  according  to 
Bancroft,  ought  not  to  have  evolved  miasm;  but  it  is  precisely 
under  such  a  condition  ot  the  atmosphere  and  earth's  surface,  that 
diseases  are  often  violent,  and  the  mortality  greatest,  agreeably  to 
Brown,  Pringle,  Fordyce.  Ferguson,  and  others  ;  and  I  now 
propose  to  examine  the  subject  in  that  point  of  view.  The  last 
named  writer,  a  standard  authority,  insists,  "  that  putrefaction  and 
the  matter  of  disease  are  altogether  distinct  and  independent ;  that 
the  one  travels  beyond  the  other  without  producing  the  smallest 
bad  effects ;  and  that  however  frequently  they  may  be  found  in 
company,  they  have  no  necessary  connection  ;"  and  that  the  cause 
of  disease  "  cannot  emanate  from  vegetable  putrefaction,  but  is 
found  most  virulent  and  abundant  on  the  driest  surfaces  ;  often, 
where  vegetation  never  existed  nor  could  exist,  &c."*  He  also  says 
"  A  year  of  stunted  vegetation,  through  dry  seasons  and  uncommon 
drought,  is  infallibly  a  year  of  pestilence  to  the  greater  part  of  the 
West  India  Islands  ;"  and  that  "  The  most  ignorant  peasant  of  Lin- 
colnshire knows  that  there  is  nothing  to  be  apprehended  from  the 
ditches  of  his  farm,  till  they  have  been  dried  up  by  the  summer 
heat."  Much  autumnal  disease  was  likewise  observed  by  him  in 
South  Holland,  in  1794,  after  a  hot  dry  summer,  at  the  encamp- 
ments of  the  British  forces,  at  Rosendaal  and  Oosterhout,  where  the 
surface  was  a  level  plain  of  dry  sand,  without  vegetation,  and 
where  no  vegetation  could  exist,  except  the  stunted  heath  plant, 
and  where  all  the  wells  of  the  camps  were  plentifully  supplied  with 
sweet  and  potable  water. 

Pringle  also  bears  testimony  to  the  insalubrity  of  the  dry, 
unproductive  sandy  plains  of  Dutch  Brabant,  whilst  Fordyce  in- 
forms us  that  the  British  Armies,  when  encamped  upon  the  pure 
sandy  plains  of  Flanders  in  1810  and  1811,  were  greatly  troubled 
with  intermittents  and  remittents ;  and,  also,  that  there  is  a  region 
in  Peru,  barren  from  want  of  water  and  vegetation,  and  yet  nearly 
uninhabitable  from  the  prevalence  of  virulent  fevers. 

The  result  of  Ferguson's  observations  on  the  medical  topo- 
graphy of  Spain,  is,  "  that  in  the  most  unhealthy  parts  of  Spain,  we 
may,  in  vain,  towards  the  close  of  summer,  look  for  lakes,  marshes, 
ditches,  pools,  or  even  vegetation  ;  and  that  Spain,  generally  speak- 
ing, though  as  prolific  of  endemic  fevers  as  Walcheren,  is,  beyond 
all  doubt,  one  of  the  driest  countries  in  Europe,  and  it  is  not  till  it 
has  again  been  made  one  of  the  wettest,  by  the  periodical  rains,  with 

^Article  on  Marsh  Poison,  &c. 


29 

its  vegetation  and  aquatic  weeds  restored,  that  it  can  be  called  heal- 
thy, or  even  habitable,  with  any  degree  of  safety." 

Dr.  Brown,  a  decided  miasraatist,  confirms  this  statement,  and 
adds:  "  He  has  repeatedly  observed  that  cases  of  fever  and  ague 
abounded  in  parts  of  Estremadura,  so  remote  from  the  Gandiana  or 
any  stream,  that  no  influence  from  visible  water  or  dampness  could 
be  supposed  to  have  a  share  in  their  production."* 

Bishop  Heb^r,  in  his  account  of  India,  according  to  Mitch- 
ell, says,  the  wood  tracts  of  Nepanl  and  Malwa,  having  neither 
swamps  nor  perceptible  moisture,  in  summer  and  autumn  are  aban- 
doned, not  only  by  man,  but  even  by  the  birds  and  beasts,  in  conse- 
quence of  their  pestilential  character.  In  regard  to  the  insalubrity 
of  woodlands,  Marchetti,  before  quoted,  observes  that,  "The  pre- 
sence of  crowded  and  extended  woods,  according  to  some,  and  on 
the  contrary,  their  destruction,  according  to  others,  cause  malaria. 
Targioni,  on  the  authority  of  Doni  and  others,  considered  woods 
injurious,  not  only  for  being  liable  to  retain  and  imprison  the  prin- 
ciple constituting  malaria,  but  also  from  being,  as  he  believed,  ca- 
pable of  producing  them.  Such  a  disparity  of  opinion  proves,  in 
my  judgment,  that  there  are  circumstances  in  which  a  too  extensive 
and  general  clearing  of  woods  may  be  equally  injurious,  as  allow- 
ing trtes  and  shrubs  to  increase  and  multiply  without  the  regulation 
of  man.  We  find  certain  districts  and  houses  with  a  perfectly 
healthy  atmosphere,  in  the  midst  of  extended  woods,  while  others 
in  similar  situations,  suffer  from  malaria." 

Malta  is  a  barren  rocky  Island,  considerably  elevated  above 
the  sea,  in  some  places  as  much  as  twelve  hundred  feet.  Its  sub- 
stratum consists  of  calcarious  sandstone,  scantily  covered  witli  soil, 
most  of  which  has  been  carried  thither.  It  has  no  marshes,  sta^-- 
nant  pools,  swampy  grounds,  lakes  or  rivers,  yet  Maj.  Tullock 
asserts  that  it  is  quite  sickly.  The  same  is  true  of  the  town  of 
Gibraltar,  which  is  built  on  a  bed  of  dry  red  sand,  at  the  foot  of  the 
rock  of  that  name,  and  has  no  ponds  or  marshes  to  furnish  decompo- 
sing vegetable  matter  to  generate  disease.  So,  too,  with  one  of  the  Isles 
de  Loss,  near  Sierra  Leone,  about  a  mile  in  diameter,  and  at  its  centre 
as  much  as  three  hundred  feet  above  the  level  of  the  sea.  It  has  no 
marsh,  no  swamp,  very  little  soil,  and  only  one  small  peice  of  ara- 
ble land,  but  it  is  represented  by  Boyle  as  one  of  the  most  insalu- 
brious spots  on  the  African  coast. 

^Cyclopedia  of  Practical  Medicine. 


30 

Here  I  might  be  satisfied  to  rest  the  discussion  of  this  question, 
Laving  already  subjected  it  to  the  test  of  the  experimentum  cruris: 
but  I  prefer  to  examine  it  still  further,  and  under  another  point  of 
view,  lest  the  miasmatists  may  think  I  have  not  furnished  them 
difficulties  enough  to  solve. 

In  a  great  many  parts    of  Kentucky,  Tennessee.  North  Alaba- 
ma, North  Carolina  and  Virginia,    where  the  country   is   dry  and 
ridgy,  and  in  many  places  quite  eievated,  autumnal  fevers  occur  up- 
on the  highest  lands,  where    there    is  comparatively    no  moisture, 
and  where  vegetable   decomposition,  to  the  extent  of  poisoning  the 
atmosphere,  is  never  suspected.     Professor  Wood  attributes  the  pre- 
valence of  intermittent  and  remittent  feveis,  under  such  circumstan- 
ces, to  an  unaccountable  epidemic  influence,    and   not  alone   to  the 
presence  of  marsh  poison  ;  for,  he   says,  speaking  of  the  effects   of 
epidemic  influences:  "Hence,  probably,  the  late  prevalence  of  inter- 
mittent and  remittent  fevers,  during  the   summer  and  autumn,  in 
portions  of  the  middle  and  eastern  States,  in    which   these  diseases 
were  formerly  almost   unknown;  while  the  circumstances  of  these 
regions,  in  relation  to  the  production  of  miasmata,  remained,  so  far 
as  could  be  discovered,  the  same  as  in  preceding  years."    The  learn- 
ed professor  does  not  exactly  acknowledge  here  the  agency  of  two 
separate  and  distinct  causes  for  the  production  of  one  and  the  same 
effect,  for  he  seems  to  be  fully  aware  how   apparently   inconsistent 
this  statement  is  with  his  previously  expressed  opinion  of  the  spe- 
cific febrile  character  of  miasmata  in  these  diseases,  and   therefore 
endeavors  to  reconcile  them,  by  supposing  that  there  is  always,  and 
in  every  place,  even  in  the  healthiest  situations,  where  there  is   no 
unusual  amount  of  moisture,  heatand  vegetation,  and  where  intermit- 
tent and  remittent  fevers  have  been  hitherto  unknown,  a  sufficiency 
of  exhalation  from  decomposing  vegetable  matter  to  produce  these 
diseases,  if  there  was  only  present  a  little  epidemic  yeast  to  enliven 
the  mass.     Now  this  view  of  the  matter,  in  my  humble  judgment, 
necessarily  leads  to  one  of  two  conclusions — either  to  the  employ- 
ment of  two  causes  for  one  effect,  which  I  have  elsewhere  stated  to 
be  at  variance  with  the  order  and   economy  of  nature,  or   amounts 
to  a  begging  of  the  question.     But  let  that  pass. 

Dr.  Robert  Jackson,  in  his  work  on  the  diseases  of  the 
West  Indies,  informs  us,  that  the  same  fevers  occur  in  those  Islands 
amongst  the  series  of  mountain  ridges,  not  exposed  to  the  exhala- 
tions from  swampy  and  low  grounds,  and  at  an  elevation  of  six  or 


31 

seven  hundred  feet  above  the  level  of  the  sea  ;  and  Dr.  Jas.  John- 
son, in  his  work  on  tropical  climates,  asserts,  that  these  diseases 
prevail  in  the  high  hills  and  thickly  wooded  parts  of  the  mountain 
ridges  of  the  Island  of  Ceylon,  and  on  the  secondary  mountains  and 
primitive  ridges  in  Sicily  ;  while  Dr.  Heyne  attempts  to  account 
for  their  occurrence  amongst  the  rocky,  wooded  hills,  in  the  Madras 
Presidency,  distant  from  any  acknowledged  sources  oi  miasms, 
by  supposing  them  to  be  owing  to  some  magnetic  influence,  depend- 
ant upon  the  ferruginous  character  of  the  rocks.  In  the  same  man- 
ner, other  distinguished  observers  have  insisted  that  these  diseases 
have  been  known  to  originate  and  prevail  extensively  in  argilla- 
ceous soil,  where  no  vegetable  putrefaction  was  going  on,  or  at  all 
suspected.*  The  celebrated  Linnaeus  contended  in  his  inaugural 
essay,  that  periodical  fevers  originated  in  all  those  places  where  the 
soil  abounds  in  clay,  and  only  in  such  places  ;  and  Yon  Aenvank,  a 
Netherlander,  endeavors  to  explain  their  prevalence  in  argillaceous 
soils,  by  supposing  that  clay  possessed  the  property  of  absorbing 
oxygen  from  the  atmospheric  air  and  thus  impairing  its  purity. 

From  Dr.  Dunglison,  we  learn  that  in  the  summer  and  au- 
tumn of  1828,  the  high,  ridgy,  and  beautiful  shores  of  Long  Island, 
known  as  the  Narrows,  received  a  fearful  visitation  from  intermit- 
tent and  remittent  fevers,  without  any  assignable  cause  for  it,  and 
when  scarcely  a  single  case  of  either  had  been  known  there  for  for- 
ty years  previously  ;  nor  does  it  appear,  says  the  Doctor,  to  have 
prevailed  there  since.  The  same  thing  has  occurred  upon  the  Is- 
land of  Portsea,  on  which  Plymouth,  in  England,  is  situated.  Many 
years  ago,  it  was  believed  to  be  entirely  freed  from  malarious  dis- 
eases by  drainage ;  but  they  have  recently  returned  again,  not  only 
to  the  best  drained  portions  of  the  Island,  but  even  to  parts  of  it 
which  were  never  beiore  subject  to  them. 

So,  in  our  own  State,  in  1846  and  1847,  districts  of  country 
hitherto  exempt  from  autumnal  fevers,  were  terribly  scourged  by 
them,  notwithstanding  there  was  no  apparent  difference  in  the 
amount  of  moisture,  heat  and  growth  of  vegetable  matter,  from 
what  was  usual  in  such  places.  The  tract  of  country  dividing  the 
waters  of  Roanoke  and  Tar  Rivers,  and  extending  from  the  neigh- 
borhood of  Weldon  on  the  former  river,  through  portions  of  the 
counties  of  Halifax,  Warren,  Franklin,  Granville  and  Person,  hav- 
ing an  argillaceous  and  gravelly  soil,  with  white  and  red  quartz 
and  granitic  formation,  the  purest  and  finest  springs  and  wells  of 


■Chisholmn,  Brown.,  and  olheis. 


to 


32       * 

water,  and  with  a  growlh  chiefly  of  oak,  hickory  and  dogwood, 
was,  during  these  years,  visited  by  autumnal  diseases,  and  in  many 
places  through  this  region,  old  men,  heads  of  large  families,  who 
had  never  taken  a  dose  of  medicine  or  seen  a  case  of  ague  and  fe- 
ver, or  bill  .us  fever,  in  their  lives,  became  as  familiar  with  these  dis- 
orders and  their  treatment,  as  with  household  words.  Other  por- 
tions of  our  State,  extending  even  into  the  gorges  of  the  mountains, 
heretofore  unfrequented  by  these  maladies,  suffered  in  a  like  unac- 
countable manner. 

These  are  some  of  the  facts  and  circumstances  which  have  in- 
duced me  to  abandon  the  miasmatic  hypothesis ;  for,  whatever  this 
febrific  agent  may  be,  if  different  from'  the  appreciable  states  of  the 
atmosphere  and  the  earth's  surface,  it  cannot  be  traced,  as  I  think 
I  have  conclusively  shown,  by  the  presence  of  those  conditions  of 
moisture,  heat,  and  vegetation,  which  are  claimed  as  indispensable 
for  its  production.  Nor  has  any  chemical  analysis,  so  far,  been  able 
to  detect  it ;  nor  microscopic  investigation,  although  conducted 
with  all  the  diligence  and  zeal  incident  to  a  fashionable  pursuit,  as 
yet  revealed  it.  M.  Julia,  a  writer  of  considerable  distinction  on 
marsh  miasm,  assures  us  that,  after  sixty  trials  to  detect  the  chem- 
ical and  physical  properties  of  this  poison  in  the  air  of  several  very 
insalubrious  marshes,  by  the  most  searching  analysis,  in  each  in- 
stance he  found  only  such  constituent  principles  as  are  contained 
in  th^  purest  atmospheric  air. 

Moschati  and  Broschi  also  examined  analytically  the  air 
of  rice  fields,  and  some  notoriously  unhealthy  spots  in  the  papal 
States,  with  nearly  like  results;  while  "M.  Deseye  obtained  in 
the  most  confined  and  unhealthy  marshes,  as  on  the  most  exposed 
hills,  seventy-eight  parts  of  Nitrogen,  twenty-one  of  Oxygen,  and 
one  of  Carbonic  acid." 

Such  is  the  view  of  this  subject  which  I  have  thought  propel 
to  present  for  your  consideration  ;  and  these  the  facts  which  the 
brief  space  allotted  to  an  address  of  this  kind  has  permitted  me  to 
bring  forward  in  support  of  my  position.  Nevertheless,  I  be- 
lieve they  will,  under  the  operation  of  the  rule  which  I  have  laid 
down  for  our  government  in  the  study  of  all  questions  in  physical 
etiology,  the  scientific  value  and  applicability  of  which  no  one  can 
deny,  furnish  sufficient  evidence  to  convince  us  that  there  is  no 
truth  in  the  doctrine  of  the  miasmatic  origin  of  disease. 


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